Pathogenesis and Treatment Strategies for Pilon Fractures With Ankle Dislocation.

The present study investigated the pathogenesis and treatment strategies for pilon fractures with ankle dislocation. A total of 58 patients (47 males and 11 females) who had sustained pilon fractures with ankle dislocation were treated. The mean patient age was 48.1 years. Using the AO classification, 8 cases were type B2, 17 were type B3, and 33 were type C3. The dislocation was medial in 13 cases, lateral in 9, anterior in 11, posterior in 14, and longitudinal in 9. Radiologic examinations were conducted to evaluate the postoperative reduction, dislocation correction, fracture healing, and internal fixation. Ankle function was evaluated according to the Kofoed and Danborg scoring system. The patients were followed up for 4 to 27 months. Anatomic reduction was achieved in 39 cases (67.24%), good reduction in 13 (22.41%), and poor reduction in 6 (10.34%). No internal implant failure occurred, and the fractures had healed after 2 to 4.3 (mean 2.8) months. The rate of good or excellent ankle recovery was 84.00% for those with type B fractures, 75.76% for those with type C, 76.92% for those with medial dislocation, 77.78% for lateral dislocation, 81.82% for anterior dislocation, 78.57% for posterior dislocation, and 81.82% for longitudinal dislocation. Pilon fractures often occur with ankle dislocation in different directions. In such cases, the original anatomy should be restored and the longitudinal alignment recovered to minimize complications as much as possible.